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[【学科前沿】] For Carpal Tunnel, Surgery Better in the Long-Term Than Corticosteroids

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发表于 2007-11-30 10:45:30 | 显示全部楼层 |阅读模式
By Megan Rauscher

NEW YORK (Reuters Health) Nov 09 - In the treatment of carpal tunnel syndrome, decompression surgery produces a better long-term outcome than local corticosteroid injections, according to data presented at the American College of Rheumatology meeting in Boston this week.

Dr. Domingo Ly-Pen, of Centro de Salud Gandhi, Madrid, reported outcomes, after a median of 5.9 years, for 148 of 163 wrists randomized to surgery or local steroid injection.

At 1 year, the results showed that local corticosteroid injection was as effective as decompression surgery, Dr. Ly-Pen and colleagues report in a meeting abstract.

However, at 7 years, the estimated accumulated incidence of therapeutic failure in the corticosteroid group was 41.8% compared with 11.6% in the surgery group.

The long-term data are not all that surprising, Dr. Ly-Pen told Reuters Health, explaining that \"the effects of corticosteroid injections fade with time.\"

He emphasized, however, that corticosteroid injections do have a role in the treatment of carpal tunnel syndrome. \"It does seem that surgery is better in the long term, but a lot of patients with carpal tunnel syndrome do not want to have surgery,\" Dr. Ly-Pen said.

He also noted that \"in our study, almost half of the patients initially injected with corticosteroids did not need any additional treatment in the 7 years follow-up.\"
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